What’s New with Beacon?

AACN National Teaching Institute May 2010

Washington D.C.

Today’s Topics

• Brief history of Beacon

• Beacon changes– Criteria– Review process – Scoring

• New resources coming soon

A Little History

• Established in 2003

• 42 questions in 6 categories

• Available for Adult Critical Care, Progressive Care and Pediatric Critical Care only

Beacon Award Program Goals

• Recognition of unit level excellence in practice and patient outcomes

• Answer the question “What does an excellent critical care unit look like?”

• Share best practices from excellent units

Success to date

• 315 units recognized since 2003

• 127 units recognized this year

• 52 units multiple winners

What We’ve Learned

• Beacon award aligns with other nationally recognized quality programs– Baldrige– Magnet– National Quality Forum (NQF)– AACN Standards for Achieving and

Sustaining a Healthy Work Environment

Alignment of Beacon Award for Excellence Criteria with other National Recognition Programs

Beacon Award for Excellence

Leadership Structures & Systems

Appropriate Staffing & Staff Engagement

Effective Communication Knowledge Management & Best Practices

Evidence-based Practice & Processes

Patient Outcomes

Baldrige National Quality Program

Leadership Workforce Focus Measurement, Analysis & Knowledge Management

Process Management Focus on Patients, other customers & markets

Healthy Work Environment

Authentic Leadership Meaningful RecognitionAppropriate Staffing

Effective Decision MakingTrue CollaborationSkilled Communication

Magnet Recognition Program

Structural EmpowermentTransformational Leadership

Exemplary Professional PracticeNew Knowledge, innovations

and improvements

Empirical outcomes

National Quality Forum Safe Practice: Leadership Structures & Systems

SP: Identification & Mitigation of Risks & Hazards

SP II: ICU (intensivists) certified

SP: Direct Caregivers (Non-Nursing Staffing)

SP 9: Nursing Workforce (Staffing)

SP 8: Care of the Caregiver Safe Practice: Teamwork

Training & Skill Building (to reduce preventable harm to patients)

SP 14: Labeling of Diagnostic Studies (Red Lab Dx)

SP 13: Order Read-Back & Abbreviations

SP 5: Informed ConsentSP 16: Computerized Prescriber

Order Entry (technology information sharing)

SP: Disclosure (Following serious unanticipated outcomes)

SP 15: Discharge Systems (hand offs)

SP 12: Patient Care Information (CPDE accessible)

Safe Practice: Culture Measurement Feedback & Intervention

SP 22: Surgical Site infection prevention

SP 21 Central Line Associated Blood Stream Infection Prevention

SP 19 Hand hygieneSP: Care of the Ventilated

Patient (DVT, PUD, Decub, VAP, VT)

SP: Medication Reconciliation

SP 29: Anticoagulation therapy (peds/neo)

SP: Life-sustaining treatmentSP 24: Multi-resistant

organism prevention (MORO)

SP 33: Falls preventionSP 32: Organ DonationSP 32: Glycemic ControlSP 27: Pressure Ulcer

PreventionSP 28: Venous

Thromboembolism Prevention

SP 25: Catheter-Associated Urinary tract Infection prevention

What We’ve Learned

• Blind review didn’t provide sufficient context for evaluation

• Review cycle too long

• We need to be able to share best practices among units

What’s the Same?

• Web-based application and feedback process

• 360 degree evaluation of your unit

• Independent review by trained reviewers

• Tools and resources available on the Beacon website

What’s Different• Award extended from 1 to 3 years

• Eliminated steps in the process – no more requests for additional information

• Focus on “how”

What’s Different

• Evaluation changed from “meets, does not meet, exceeds” to numerical scoring to allow units to measure improvement over time

• Implemented 3 levels of award – bronze, silver and gold

What’s Better

• Added unit profile to fully describe the relationships and structure of your unit

• Expanded criteria to allow any unit where patients receive their principle nursing care after admission to apply

• Addition of Executive Summary to feedback

2010 Beacon Criteria

Beacon Categories

2010 2003Unit Profile

Leadership Structures & Systems

Leadership/Organizational Ethics

Appropriate Staffing and Staff Engagement

Recruitment & Retention, Education Training & Mentoring

Effective Communication, Knowledge Management & Best Practices

Healing Environment

Evidence-based Practice and Processes

Evidence-Based Practice/Research

Patient Outcomes Patient Outcomes

Unit Profile• Key characteristics that define your work

group, unit or microsystem

Leadership Structures & Systems

• How unit leaders ensure a healthy work environment that delivers the best care for patients and families

• 150 points

Appropriate Staffing & Staff Engagement

• How the unit engages, manages and develops staff?

• 100 points

Effective Communication, Knowledge Management & Best Practices

• How the unit ensures effective communication, staff competency and management of knowledge sharing

• 100 points

Evidence-based Practice and Processes

• How staff are engaged to achieve better patient outcomes, improve processes and stay current with evidence-based practice and research

• 200 points

Patient Outcomes

• The unit’s key nurse-sensitive patient outcome measures and results

• 450 points

Application & Review Process

• On-line application submission and payment process– $1,500 for 3 year designation

• 38 questions in 6 areas

• Text and charts

Application & Review Process

• Independent review & score

• Senior review – Executive summary– Final score

• Feedback report

Award LevelsBeacon Award for Excellence

Bronze Award

Beacon Award for Excellence

Silver Award

Beacon Award for Excellence

Gold Award

1. Overall score of 250 – 400 points

2. Most scores at or above 25%

1. Overall score of 350 – 700 points

2. Most scores at or above 50%

3. Few major gaps in any area

1. Overall score of over 650 points

2. Most scores at or above 70%

3. No major gaps in any area

0 - 25% 30 - 50% 55 - 75% 80 - 100%Approach Policy Procedures Processes

No systematic approach is evident, although there may be some anecdotal evidence.

The beginning of a systematic approach to formal policies, procedures and/or processes is evident

An effective, systematic approach is evident, although there may be gaps in some areas. May include basic or surveillance approaches.

An effective, systematic approach, with no gaps is evident.

Application 100% Know & Can Apply

The approach is in the early stages of application in most components. This may represent little or no application of a systematic approach.

The approach is applied to some components and/or in the early stages of others. Some gaps or weaknesses may be evident.

The approach is well applied to most components, although some gaps may be evident.

The approach is fully applied without significant weaknesses or gaps in any components.

Learning In-Process Measures Evaluation

The unit is in the early stages a transition from reacting to problems to a general improvement orientation.

The unit is beginning a systematic approach to evaluation and improvement of key processes.

This unit uses a fact-based, systematic evaluation and improvement process and some use of evidence-based approaches, subject matter experts, and/or benchmarks.

This unit uses fact-based, systematic evaluation and improvement strategies. Tools, refinements and innovations are backed by analysis and sharing and are evident throughout the 24/7 operations.

Scoring Band

Criteria 1: Leadership Structures & Systems - total 150 pointsCriteria 2: Appropriate Staffing & Staff Engagement - total 100 points

Criteria 4: Evidence-Based Practice & Processes - total 200 pointsCriteria 3: Effective Communication, Knowledge Management & Best Practices - total 100 points

Process Evaluation Factor Score Summary - For Criteria 1-4

The overall score is NOT intended to be a numerical average of the elements above; select the range and score that is MOST descriptive of the unit's achievement level for each item.

0 - 25% 30 - 50% 55 - 75% 80 - 100%Levels None to few performance results or

poor performance levels in areas reported.

Some performance results are reported, and early good performance levels are evident in a few areas.

Performance results are reported for many to most areas, and good performance levels are evident in most areas of relevance to the practice setting.

Performance results are reported for all areas, and good to excellent performance levels are reported in most areas of relevance to the practice setting.

Trends Trend data either are not reported or show mainly adverse trends.

Some trend data are reported, and majority of the trends presented are favorable.

Trend data is reported for many to most areas of importance or relevance to the practice setting, representative of the population served, and the majority of the trends presented are favorable.

Trend data is reported for all areas of importance or relevance to the practice setting, representative of the population served. Favorable trends have been sustained over time.

Comparisons Little or no comparative information is reported. If comparative information is reported, unit's results are not at national minimum requirements.

Some current performance measures have been evaluated against relevant comparisons, benchmarks, national measurement criteria, or national nursing sensitive outcome indicators, and show areas of good relative performance.

Many to most current performance measures have been evaluated against relevant comparisons, benchmarks, national measurement criteria, or national nursing sensitive outcome indicators and show areas of very good performance. There may be evidence of achieving better than benchmark results in some areas.

Evidence of industry and benchmark leadership is demonstrated in many areas.

Scoring Band

Results Evaluation Factor Score Summary - For Criteria 5

The overall score is NOT intended to be a numerical average of the elements above; selectthe range and score that is MOST descriptive of the unit's achievement level for each item.

Criteria 5: Patient Outcomes - total 450 points.

Scoring

• Unit will receive a score for each area– Leadership Structures & Systems– Appropriate Staffing & Staff Engagement– Effective Communication, Knowledge

Management & Best Practices– Evidence-based Practices & Processes– Patient Outcomes

Scoring

• Category scores will be multiplied by the total number of points available for that category

Example - Leadership

150 points * 60% score = 90 points

Scoring

• Leadership• Staffing• Communication• Evidence-based practice• Patient outcomes• Total Points

150 * 50% = 75

100 * 65% = 65

100 * 55% = 55

200 * 60% = 120

450 * 40% = 180

495

Resources

• Beacon Criteria Brochure – May

• Beacon Audit Tool - May

• Applying for the Beacon Award for Excellence Webinar – July

Next Steps

• Read the entire application booklet• Review the scoring system• Understand the meaning of key terms in the

glossary• Prepare the unit profile• Complete the Beacon assessment tool• Develop & submit your application

September October November DecemberMay J une J uly August

5/15Beacon criteria launch on website

11/1Beacon 2.0 Launch

Beacon 2.0 Launch

6/1Beta testing begins, & open COP to testers

mid-OctoberReviewer training

7/30Applying for Beacon Webinar

9/1BeaconReviewers selected

Questions?

Thank you for pursuing excellence

tracy.barron@aacn.org

justine.medina@aacn.org